Many people are familiar with the saying that a woman is “eating for two” during pregnancy. Although this is an exaggeration, nutritional needs do certainly increase during pregnancy to support the growing baby.

But what’s perhaps less known is that energy needs are actually even slightly higher during breastfeeding than during pregnancy.

Human breastmilk is a dynamic liquid and its composition (including carbohydrates, fats, proteins, vitamins and minerals) varies over the entire breastfeeding period, and even between feeds.

It can change depending on what mum is eating, environmental factors, and what the baby needs, through a biofeedback system (sometimes called “baby backwash”). For example, if a baby is starting to get sick, breastmilk will adjust to include more leukocytes, immune cells that fight infection.

So what should breastfeeding women be eating? And how does a mother’s diet influence the nutritional makeup of her milk?

Nutritional needs increase during breastfeeding

Fully breastfeeding mums can produce around 800 millilitres of milk a day in the first six months after birth, which has an energy content of roughly 3 kilojoules per gram.

Even factoring in using up excess fat stored during pregnancy, mums still need on average an extra 2,000 kilojoules to support milk production. This is roughly equivalent to adding a cheese sandwich, a handful of nuts and a banana on top of normal dietary intake.

Interestingly, requirements don’t drop off after the baby starts solids. In the second six months, milk production is thought to drop to an average of 600ml per day, as babies start to eat solid foods. But because maternal fat stores deplete by this stage, additional energy requirements remain similar.

Some nutrients are particularly important during breastfeeding, including protein, calcium, iron, iodine and vitamins.

For example, compared with a non-pregnant, non-breastfeeding woman, protein requirements increase by almost half when breastfeeding (from 0.75 grams to 1.1 grams per kg of body weight per day).

Meanwhile, iodine requirements almost double (from 150 micrograms per day to 270 micrograms per day). Iodine is important for thyroid function, and can impact baby’s growth and brain development.

It’s important women who are breastfeeding eat a variety of foods, including:

• high-protein foods (meat, fish, eggs, nuts, seeds, soy-based protein such as tofu and tempeh, legumes such as chickpeas, baked beans and lentils)
• dairy foods or alternatives (for dairy alternatives, check calcium is included)
• whole grains
• fruits and vegetables.

While making all that milk, drinking more water also becomes extremely important. Thirst is a good guide, but around 2.5 litres per day is generally recommended, or more if it’s hot or with exercise.

Is there anything I shouldn’t be eating?

What a mum consumes can pass into her breastmilk. For example, in one study, babies whose mothers drank small amounts of carrot juice while breastfeeding were more accepting of cereal flavoured with carrot juice compared with a control group of babies whose mothers drank water.

It’s therefore important to limit alcohol and caffeine, which can also pass though to the baby. No alcohol is the safest choice, but if you’re planning to have a drink, tools such as the Feed Safe app can be used to estimate when your breastmilk should be free of alcohol.

Up to 200mg of caffeine per day (equivalent to roughly a cup of brewed coffee, an energy or cola drink, or four cups of tea) is considered safe for breastfeeding.

Breastfeeding mums don’t need to take any particular foods out of their diet to prevent allergies in their baby. In fact, experts believe babies exposed to common allergens via breast milk could be less likely to develop allergies to these foods, however we need more research into this question.

Although relatively uncommon, babies can be allergic or intolerant to certain aspects of their mothers’ diet when breastfeeding. They may react in the form of colic or wind, reflux, mucus or blood in their poo, eczema or rash, or appear to be in pain.

In these cases, mum’s diet may need adjustment. The most common culprits include cows’ milk (the protein, not the lactose component), soy and egg.

It’s recommended to remove suspected foods from the diet for a minimum of three weeks. This should ideally be done with supervision from an Accredited Practising Dietitian who specialises in allergy, to ensure the mother’s nutritional needs continue to be met.

4 tips for breastfeeding mums

1. it’s a good idea to get a blood test to check your vitamin D and iron levels – these can be depleted over pregnancy and are important for breastfeeding. If your levels are low, you can discuss options with your doctor
2. iodine requirements are so much higher in breastfeeding that an iodine supplement of 150 micrograms a day is recommended to support infant growth and neurodevelopment
3. have a variety of nutritious snacks that can be eaten with one hand for those late-night feeds, such as peeled boiled eggs, a peanut butter sandwich on wholegrain bread, or avocado and cheese on a rice cake. My personal favourite is homemade rocky road with dark chocolate, nuts, seeds and dried fruit
4. keep a drink bottle with water nearby when breastfeeding.

If you’re considering a gift for a family with a new baby, remember new parents’ personal needs often take a back seat when bub arrives, including eating well. Consider a hearty frozen meal, muffins with oats and nuts, a nice stainless steel water bottle, gourmet trail mix or even some homemade rocky road.

Therese O’Sullivan, Associate Professor in Nutrition and Dietetics, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

When most people think about “healthy eating”, they usually focus on what they eat. That might mean trying to eat more fruit and vegetables or less fast food, or counting calories.

But there’s a lot more to healthy eating than just dietary intake. Behaviours and attitudes around food are also important.

Take, for example, orthorexia nervosa, which is an obsessive preoccupation with consuming only “healthy” foods. If healthy eating only means ingesting healthy foods, then people with orthorexia are super healthy.

But people who live with this eating disorder often struggle with relationships and report poor quality of life, among other issues.

Research suggests that shifting the focus from food itself to our experience of eating can have a range of health benefits. Let’s take a look.

Why are we so obsessed with diet?

Equating “healthy eating” with “healthy diet” may have taken off in the early 1980s with panic over the “obesity epidemic” in Western countries – defined as a rapid rise in the prevalence of people in the population with a body mass index (BMI) of 30 or greater.

But causes of obesity are complex and poorly understood, with numerous possible explanations beyond simply what a person eats. And admonishing overweight people to eat “healthier” has done nothing to reduce population rates of obesity.

There is some evidence that this fixation on weight has resulted in increased rates of disordered eating and eating disorders – both of which involve problematic eating behaviours and distorted attitudes towards food, weight, shape and appearance.

Clearly, something needs to change in how we think about healthy eating.

Listening to your body

A growing body of research on intuitive eating has found this approach has an array of health benefits.

Intuitive eating means trusting internal body cues that tell us when, what and how much to eat. For example, tuning into your stomach growling telling you it’s time to eat, or noticing feeling full or satisfied, or that you may crave certain foods because your body wants specific nutrients (such as protein after exercising).

Studies have shown this approach can lead to better physical and mental health as well as better diet quality, and is associated with lower BMIs.

Research also shows eating at regular intervals and eating with other people also lead to better overall health and diet.

But if you find it hard, you’re not alone

Most of us are surrounded by food environments that make healthy eating difficult.

Unhealthy food environments promote overeating and encourage us to override our innate signals of hunger and fullness.

When we’re surrounded by cheap and accessible sugary snacks, fast foods and large portions – and lots of marketing – it can be hard to develop a positive relationship with food.

The issue is particularly acute for people in more disadvantaged communities.

For example, in our research with rural Australians about food and eating, most told us they wanted to eat more healthily, but found it difficult for many reasons, These included busy schedules and the cost of healthier food.

Habits and emotional eating can also make healthy eating difficult.

So, what works?

For most people, healthy behaviours and attitudes to eating mean a balanced, flexible and non-judgmental approach, without fear of “bad” foods. It means paying attention to hunger and fullness cues.

But it also means recognising that food is a source of social and cultural connection. A healthy attitude to food doesn’t ignore nutritional information – it incorporates this knowledge into a broader and more joyous approach to eating.

Here are three suggestions to get you started.

1. Recognising signs of hunger and fullness

These may differ from person to person. Can you hear your stomach start to growl or your energy begin to dip? Is it a while since you ate? And while eating, is there a point where the hunger has gone away and you no longer feel a strong desire to continue eating? Some people find using hunger and fullness scales useful.

2. Reframing “bad” foods

Is there a food you really like but don’t eat because you consider it “bad” or “forbidden”? Try incorporating a small amount into your next meal or snack. You may find that doing so brings greater joy to your eating while simultaneously taking away its power.

3. Eating with people

If you normally eat by yourself or “grab and go”, see if there’s a way to plan more time for meals and include other people – whether this is more family meals or group lunches with coworkers.

But some people have to follow a specific diet

People with medical conditions that require a particular type of diet – such as those with diabetes or coeliac disease – need to follow that advice. But they may still be able to have healthy behaviours and attitudes towards food even within these constraints.

For example, one 2020 study of people with type 2 diabetes found that more intuitive eaters had better control of their blood sugar levels.

The bottom line

So – if you don’t have a medical condition that prevents it – go ahead and have some of that birthday cake. And then listen to your body when it tells you you’ve had enough.

If you feel that you have an unhealthy relationship with food that is interfering with your life, please contact your GP to discuss your options. You may also want to contact the Butterfly Foundation for support.

Nina Van Dyke, Associate Professor and Associate Director, Mitchell Institute, Victoria University and Rosemary V. Calder, Professor, Health Policy, Victoria University

This article is republished from The Conversation under a Creative Commons license. Read the original article.